GROWTH, DEVELOPMENT AND BEHAVIOR

Newborn ( neonatal) period: begins at birth and include the 1 st month of life.

Newborn ( neonatal) period: begins at birth and include the 1 st month of life.

Physical examination: term newborn Average weights: 3.4 kg (7 ½ lb) Average length: 50cm (20 in) head circumference: 35 cm (14 in)

Average weights: 3.4 kg (7 ½ lb)

Average length: 50cm (20 in)

head circumference: 35 cm (14 in)

Hearing is well developed

Hearing is well developed

Behavioral state: Quite sleep Active sleep Drowsy Alert Fussy Crying

Quite sleep

Active sleep

Drowsy

Alert

Fussy

Crying

Behavioral state determines an infant’s muscle tone, spontaneous movement, electroencephalogram pattern and response to stimuli.

Behavioral state determines an infant’s muscle tone, spontaneous movement, electroencephalogram pattern and response to stimuli.

Developmental milestones in the first 2 yr of life

Gross motor: Hold head steady while sitting Pulls to sit, with no head lag Brings hands together in midline Sits without support Rolls back to stomach Walks alone Runs 2 mos 3mos 3mos 6mos 6.5mos 12mos 16m0s

Hold head steady while sitting

Pulls to sit, with no head lag

Brings hands together in midline

Sits without support

Rolls back to stomach

Walks alone

Runs

2 mos

3mos

3mos

6mos

6.5mos

12mos

16m0s

Fine motor: grasps rattle Reaches for object Palmar grasp done Transfers object from hand to hand Thumb-finger grasp 3.5mos 4mos 4mos 5.5mos 8mos

grasps rattle

Reaches for object

Palmar grasp done

Transfers object from hand to hand

Thumb-finger grasp

3.5mos

4mos

4mos

5.5mos

8mos

Communication and language: Smiles in response to face, voice Monosyllabic babble Inhibits to NO Follows one-step command w/ gesture Follows one-step command w/o gesture Say mama or dada Points to object Speaks first real word Speaks 4-6 words Speaks 10-15 words Speaks 2 word sentences 1.5mos 6mos 7mos 7mos 10mos 10mos 10mos 12mos 15mos 18mos 19mos

Smiles in response to face, voice

Monosyllabic babble

Inhibits to NO

Follows one-step command w/ gesture

Follows one-step command w/o gesture

Say mama or dada

Points to object

Speaks first real word

Speaks 4-6 words

Speaks 10-15 words

Speaks 2 word sentences

1.5mos

6mos

7mos

7mos

10mos

10mos

10mos

12mos

15mos

18mos

19mos

cognitive: Stares momentarily at spot where object disappeared Stares at own hand Uncovers toys Egocentric symbolic play Uses stick to reach toy Pretend plays with doll 2mos 4mos 8mos 12mos 17mos 17mos

Stares momentarily at spot where object disappeared

Stares at own hand

Uncovers toys

Egocentric symbolic play

Uses stick to reach toy

Pretend plays with doll

2mos

4mos

8mos

12mos

17mos

17mos

The first year of life Age 0-2 months: Tremendous growth Effective feeding routines Predictable sleep-wake cycle

Age 0-2 months:

Tremendous growth

Effective feeding routines

Predictable sleep-wake cycle

Physical development: Weight decrease 10% below birthweight in the first week as a result of excretion of excess extravascular fluid and limited intake.

Weight decrease 10% below birthweight in the first week as a result of excretion of excess extravascular fluid and limited intake.

Infant regain or exceed birth weight by 2 weeks of age and should grow at approx 30 gms/day during the first month. Period of fastest postnatal growth. Smiling occurs involuntarily. Recognition memory. Sleep and wakefulness are evenly distributed throughout the 24hr day Learning also occurs.

Infant regain or exceed birth weight by 2 weeks of age and should grow at approx 30 gms/day during the first month.

Period of fastest postnatal growth.

Smiling occurs involuntarily.

Recognition memory.

Sleep and wakefulness are evenly distributed throughout the 24hr day

Learning also occurs.

Cognitive development: Infants habituate to the familiar, attending less and less to repeated stimuli and increasing their attention when the stimulus changes. Infant can differentiate among patterns, colors and consonants. Recognize facial expression

Infants habituate to the familiar, attending less and less to repeated stimuli and increasing their attention when the stimulus changes.

Infant can differentiate among patterns, colors and consonants.

Recognize facial expression

Emotional development: Dependent on the environment to meet his or her need.

Dependent on the environment to meet his or her need.

Age 2-6 month: Voluntary social smile. Increasing eye contact

Voluntary social smile.

Increasing eye contact

Physical development: Between 3 and 4 months of age, the rate of growth slows to approx 20gm/day. By 4 month, birth weight is doubled. Grasp reflex Roll over Regular sleep wake cycle

Between 3 and 4 months of age, the rate of growth slows to approx 20gm/day.

By 4 month, birth weight is doubled.

Grasp reflex

Roll over

Regular sleep wake cycle

Cognitive development: Qualitative change 4 months of age infants are described as hatching socially Explore their own bodies Sense of self – first stage of personality development

Qualitative change

4 months of age infants are described as hatching socially

Explore their own bodies

Sense of self – first stage of personality development

Emotional development and communication: Distinct facial expressions Initiating games, increases social development.

Distinct facial expressions

Initiating games, increases social development.

Ages 6-12 months Shows advances in cognitive understanding and communicative competence. Develop will and intentions

Shows advances in cognitive understanding and communicative competence.

Develop will and intentions

Physical development: Growth slows more By the first bday, birth weight has tripled, length has increased by 50%, and head circumference has increased by 10cm.

Growth slows more

By the first bday, birth weight has tripled, length has increased by 50%, and head circumference has increased by 10cm.

Sit unsupported (6-7mos) Pivot while sitting (9-10mos) Thumb finger grasp (8-9mos) Neat finger grasp by 12 mos Pulling to stand by 8mos Walk by 1yr

Sit unsupported (6-7mos)

Pivot while sitting (9-10mos)

Thumb finger grasp (8-9mos)

Neat finger grasp by 12 mos

Pulling to stand by 8mos

Walk by 1yr

Motor achievements correlate with increasing myelinization and cerebellar growth. Tooth eruption occurs, usually starting with the mandibular central incisors Tooth development reflects skeletal maturation and bone age.

Motor achievements correlate with increasing myelinization and cerebellar growth.

Tooth eruption occurs, usually starting with the mandibular central incisors

Tooth development reflects skeletal maturation and bone age.

Cognitive development: At first everything goes into the mouth. A major milestone is the achievement at about 9 mos. Of object permanence (constancy)

At first everything goes into the mouth.

A major milestone is the achievement at about 9 mos. Of object permanence (constancy)

Emotional development: Stranger anxiety Poor weight gain Tantrums

Stranger anxiety

Poor weight gain

Tantrums

Communication: 7mos adept of non verbal communication 9mos aware of the emotions 8 and 10mos babbling takes Social interaction First true word

7mos adept of non verbal communication

9mos aware of the emotions

8 and 10mos babbling takes

Social interaction

First true word

The second year Age 12-18mos: Physical development: Growth rate slows further in the 2 nd yr of life Appetite decline Increase in head circumference of 2cm over the yr.

Age 12-18mos:

Physical development:

Growth rate slows further in the 2 nd yr of life

Appetite decline

Increase in head circumference of 2cm over the yr.

Cognitive development: Exploration of the environment increases and mobility Playthings Imitation of parents and older children Symbolic play

Exploration of the environment increases and mobility

Playthings

Imitation of parents and older children

Symbolic play

Emotional development: Predominant mood changes Tantrum

Predominant mood changes

Tantrum

Linguistic development: Infants speak their first words Respond appropriately to several simple statement Points to major body parts and uses 4-6 words spontaneously and correctly

Infants speak their first words

Respond appropriately to several simple statement

Points to major body parts and uses 4-6 words spontaneously and correctly

Age 18-24 months: Physical development: Height and weight increase at a steady rate, w/ gain of 5in and 5lb. By 24mos, children are about ½ of their ultimate adult height. Head growth slows slightly 90% of adult head circumference is achieved by age 2 yrs.

Physical development:

Height and weight increase at a steady rate, w/ gain of 5in and 5lb.

By 24mos, children are about ½ of their ultimate adult height.

Head growth slows slightly

90% of adult head circumference is achieved by age 2 yrs.

Cognitive development: Object permanence is firmly established Cause and effect are better understood

Object permanence is firmly established

Cause and effect are better understood

Emotional development: Separation anxiety Self-conscious awareness

Separation anxiety

Self-conscious awareness

Linguistic development: Most dramatic development Childs vocabulary balloons, the beginning of grammar Understand 2-step commands

Most dramatic development

Childs vocabulary balloons, the beginning of grammar

Understand 2-step commands